Gastrointestinal tract lymphangiomas: findings at CT and endoscopic imaging with histopathologic correlation

Objective  To evaluate and describe CT and endoscopic imaging findings in patients with pathologically confirmed gastrointestinal tract lymphangiomas. Methods  Findings from imaging examinations in 6 patients with pathologically confirmed lymphangioma were retrospectively reviewed (computed tomographic images obtained in 6 patients and endoscopic images obtained in 4 patients were available for review). Two radiologists evaluated lesion location, size, shape, edge, number, attenuation, the thickness of capsule wall and the degree of enhancement through PACS or workstation. Results  Lymphangiomas in gastrointestinal tract showed similar features in CT imaging: Contrast-enhanced CT scan showed the oval submucosal masses with homogeneous low attenuation. The lymphangioma appeared as a well-defined, smoothly marginated and non-enhancing cystic mass with intact overlying intestinal mucosa. In one case, the lymphangiomas were multiple with volvulus. Remarkably, CT imaging showed 2 patients with intussusception due to the mass. Endoscopic photographs manifested multiple colplanate mucosal protrusions in the gastric wall or intestinal wall. One case showed submucosal pedunculated proliferative lesion with adenomatous surface. Conclusions  Lymphangiomas exhibited typical appearances that reflected their cystic pathologic features. They showed similar features in CT imaging: well-demarcated, non-enhancing, homogeneous low attenuation cystic masses with intact overlying mucosa. Endoscopic photographs showed submucosal masses with distension of overlying mucosal vessels.     

胰腺囊性病变的诊断与处置进展

本文对胰腺囊性病变的临床表现、病理分类、影像学诊断、鉴别诊断及临床处置的进展进行了介绍,着重介绍胰腺囊性病变的超声、CT、MRI等影像学表现的特征.     

Intraductal papillary mucinous neoplasms of the pancreas: Correlation of helical CT features with pathologic findings

Objective

To evaluate the CT features of intraductal papillary mucinous neoplasms of the pancreas (IPMNs), and to compare with pathological findings in order to identify CT features that can be helpful in differentiating benign IPMNs from malignant IPMNs.

Materials and methods

The CT findings in 25 patients were reviewed for tumor location, tumor type, dilatation of the main pancreatic duct (MPD), MPD involvement, mural node or solid attenuating component, tumor size in branch duct or mixed duct type, dilatation of common bile duct (CBD) and invasion of surrounding structures. The data was subjected to Chi-Square Tests or Fisher's Exact Test using SPSS13.0 software with p value < 0.05 indicating significant statistical difference.

Results

Presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, dilatation of CBD was more common in malignant IPMNs (p < 0.05). None of tumor location, tumor type, dilatation of MPD, MPD involvement, tumor size, and invasion of surrounding structures was statistically significant in differentiating benign from malignant IPMNs.

Conclusions

CT features suggestive of malignant or invasive IPMNs include presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, and dilatation of CBD.     

Therapeutic endoscopy of localized gastric varices: pretherapy screening and posttreatment evaluation with MDCT portography

Background  

Gastric varices are a major cause of gastrointestinal bleeding in patients with portal hypertension. Whatever therapeutic method is used, hemodynamic changes in the portal systemic shunt should be assessed. In this study, we used multi-detector row CT portography as a screening and assessment tool.     

SOLID PSEUDOPAPILLARY TUMOR OF THE PANCREAS： CLINICAL AND COMPUTED TOMOGRAPHIC FINDINGS WITH PATHOLOGIC CORRELATION IN 21 CASES

Objective To correlate the clinical and imaging features of the solid pseudopapillary tumor (SPPT) of the pancreas with the pathologic diagnosis. Methods The computed tomographic findings in 21 patients (18 women and 3 men) with pathologically proven solid pseudopapillary tumor of the pancreas were reviewed retrospectively. Two radiologists reviewed images for location, size and morphology, capsule and margin, density, enhancement pattern, calcification, dilatation of pancreatic duct, lymphadenopathy, vascular invasion, distant metastasis, and recurrence. Results On CT, the lesion presented as solitary, round (28.57%), oval (57.14%), or lobulated (14.28%) mass in pancreatic head (47.62%) with complete capsule (85.71%). Lesions smaller than 4cm in maximum diameter (47.62%) presented as predominantly solid mass whereas lesions greater than 4cm in diameter (52.28%) presented as heterogenous mass. On contrast administration, the viable solid portion of the tumor showed mild peripheral enhancement in arterial phase [enhancement degree<20Hounsfield unit (HU)] with progressive fill in during the portal and hepatic parenchyma phase (enhancement degree 20-40HU). Eighteen lesions (85.7%) had complete capsule. Two lesions (9.5%) had areas of high density (>60HU) on plain CT which due to hemorrhage. Dilatation of the pancreatic duct was rare (25%), and distant metastasis, regional lymphadenopathy, and tumor recurrence were absent. Nine patients (42.85%) had an abdominal CT follow-up for 24.55months (range, 2-60months) post-surgery without recurrence or distant metastasis. Conclusion Solid pseudopapillary tumor of the pancreas usually occurs in young females in the pancreatic head or tail. On CT, they manifest as moderate vascular mixed tumor, progressive enhancement of the viable solid portion, distinct tumor margin with capsule formation, and absence of regional lymphadenopathy.     

In vitro antimicrobial activity of o-phenylenediamine-tert-butyl-N-1,2,3-triazole carbamate analogs

In an attempt to design and synthesize effective antimicrobial agents using click chemistry, mono- and di-alkyne-substituted monoboc protected o-phenylenediamines were reacted with different substituted aryl azides which yielded 18 new compounds (4a–4k and 5a–5f, 5l). Structures of all newly synthesized compounds were established by ¹H and ¹³C NMR analysis. The intermediate compound 1 was also confirmed by X-ray crystallography. The title compounds were screened for their antibacterial activity against Gram +ve bacteria (Staphylococcus aureus and Enterococcus faecalis), Gram ?ve bacteria (Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa), and their antifungal profile were tested on (Candida tropicalis, Candida albicans, Candida krusei, and Cryptococcus neoformans) as well as on molds such as (Aspergillus niger, Aspergillus fumigatus). The compounds 4k and 5f both showed maximum potency against S. aureus (ATCC 25323) strain with MIC value of 6.25 µg/ml, which is comparable with standard drug ciprofloxacin (MIC 6.25 µg/ml) while remaining compounds showed moderate to weak activity. Further, all compounds showed average antifungal activity in the range of 100–200 µg/ml.     

A symphony of signals conducts early and late stages of adult neurogenesis

Neurogenesis is continually occurring in two regions within the mammalian central nervous system (CNS) and increasing evidence suggests that it is important for selective learning and memory. How this plasticity is maintained in isolated niches within mature networks has been extensively studied in recent years, and a large body of evidence has accumulated describing many different regulatory factors and points of regulation. In this review, we attempt to organize the current research by summarizing findings affecting early neurogenesis: during proliferation, fate commitment and migration, versus late neurogenesis: including dendritic development, synaptic integration, and survival. We discuss the roles of three different classes of factors regulating early and late phases of neurogenesis: intrinsic factors, extrinsic factors, and neurotransmitters. Finally, we suggest that neurotransmitters may act upstream from extracellular other factors and cell-intrinsic mechanisms by coupling network activity to the niche microenvironment and intracellular machinery to ultimately regulate neurogenesis.     

Hepatoid adenocarcinoma: computed tomographic imaging findings with histopathologic correlation in 6 cases

OBJECTIVE: Hepatoid adenocarcinoma (HAC) is a special type of primary tumor with aberrant hepatocellular differentiation occurring in extrahepatic organs. Our objective was to review the computed tomographic findings of HAC and to correlate the imaging features with histopathologic findings. Institutional review board approval was obtained for this study. METHODS: The computed tomographic findings images in 6 consecutive patients with pathologically proven HAC were reviewed retrospectively. Five patients were men and 1 was a woman (mean age, 56 years; age range, 36-68 years). All patients underwent contrast-enhanced computed tomography (CT) performed on a 4-slice multidetector row CT scanner. The mean time interval between CT and surgery was 5 days. Two radiologists who were unaware of the final histological diagnosis reviewed all computed tomographic images retrospectively. Lesion characteristic (ie, number, location, size, density, enhancement, heterogeneity, margin, distribution, presence of necrosis, lymphadenopathy, and distant metastasis) were evaluated. The correlation between the imaging and the pathological findings was analyzed. RESULTS: Most patients had elevated serum alpha-fetoprotein levels (n = 4). The HAC appeared as large tumors (mean size, 4.2 x 3.4 x 3.9 cm), isodense at unenhanced CT (n = 4), moderately enhanced (n= 5), with necrotic areas (n = 6), regional lymphadenopathy (n = 5), and distant metastases (n = 4). The heterogeneity on computed tomographic images correlated well with the presence of hemorrhage and necrosis. CONCLUSIONS: In an old patient with a large necrotic and moderately vascular tumor, the presence of distant metastases, regional lymphadenopathy, and characteristic increased serum alpha-fetoprotein level may suggest a diagnosis of HAC.     

肾嗜酸细胞瘤的影像学诊断

目的:探讨肾嗜酸细胞瘤(RO)的影像学表现,以提高对其诊断的准确性。方法:回顾性分析经病理证实的12例RO患者的影像资料。12例均行MSCT平扫及多期增强扫描,包括肾皮质期、髓质期和排泄期(5例)增强扫描;有3例同时行MRI检查。结果:CT平扫示12例病灶均为单发,7例位于左肾,5例位于右肾,最大径2.0~11.6cm,平均5.8cm,<3.0cm者3例。增强扫描:肾皮质期示10例病灶明显强化,其中8例强化低于肾皮质,2例强化接近于肾皮质;肾髓质期示7例病灶强化程度下降并低于肾脏髓质的密度,3例病灶持续强化、于排泄期见密度开始下降,2例病灶在皮质期~排泄期表现为持续强化;6例病灶内可见星芒样瘢痕,8例有完整包膜,3例可见钙化。3例病灶于MRIT1WI上呈等、低信号,T2WI呈相对均匀的高信号,3例均见完整包膜。结论:RO的影像学表现有一定特征性,多表现为增强后均匀强化,无囊变或坏死,T2WI上可见完整的低信号包膜,有助于同各类型肾癌鉴别。